PHYSICIANS KNOWLEDGE OF GENETICS AND GENETIC TESTS

Purpose. To assess primary care physicians' and psychiatrists' knowled ge of genetics and genetic tests and the factors associated with diffe rences in these physicians' knowledge. Method. Questionnaires were mai led in 1991 to 1,795 primary care physicians (family physicians, inter nists, pediatricians, obstetrician-gynecologists) and psychiatrists wh o had graduated from medical school between 1950 and 1985 (67.6% of th e sample had graduated after 1970) and who were members of professiona l societies. The questions elicited demographic and practice character istics as well as knowledge of genetics concepts and facts and awarene ss of the availability of genetic tests. To validate the questionnaire , 360 medical geneticists and genetic counselors received questionnair es. Statistical analysis involved are-sine function transformation, t- tests, analyses of variance, F-tests, Tukey's HSD, and stepwise multip le regression. Results. A total of 1,140 (64.8%) of the non-geneticist physicians responded. They correctly answered an average of 73.9%, SD , 13.9%, of the knowledge items, compared with 94.6%, SD, 4.2%, for th e genetics professionals (p <.001). The most significant predictors of knowledge were recency of graduation from medical school and practici ng in primary care specialties in which exposure to genetics problems is likely. Other significant predictors (from most to least important) were graduation from a U.S. medical school, willingness to adopt a ne w predictive test before it becomes standard practice, not using pharm aceutical companies as a source of information about new medical pract ices, and taking a required genetics course in medical school. Conclus ions. The results suggest that knowledge of genetics and genetic tests is increasing among physicians, particularly among more recent gradua tes and physicians who are exposed to genetics problems in their pract ices, but deficiencies remain. Although a medical school course in gen etics may improve knowledge, it is not sufficient. Greater emphasis is needed at all levels of medical education to reduce the chance of phy sician error as more genetic tests become available.